In Australia there is some interest in wraparound or individualised models of care as an alternative to traditional modes of child welfare funding and service delivery. This article points to the origin and core principles that guide attempts to create this post-institutional pattern of service. Following this a definition of wraparound or individualised services is offered. The current state of US research into the effectiveness of services provided under this rubric is then reported. Finally, comment is offered about the relevance of wraparound and individualised forms of service for Australian child welfare.
Even though there is interest in `wraparound' or individualised models of care as an alternative to traditional modes of child welfare funding and service delivery (Clark, 1997; Department of Human Services, 1997; Association of Children's Welfare Agencies, 1998) many Australian readers may be unfamiliar with this US concept. The origin of this service format is in attempts to conceptualise `a comprehensive coordinated system of care for severely emotionally disturbed children and youth' in a post-institution environment (Stroul and Friedman, 1988). These children are those served by state departments of mental health, developmental disability and special education in the US. However, there is some overlap between these populations and those served by state child welfare authorities that exist as separate departments.
The principles put forward by Stroul and Friedman (1988) as forming the base of a comprehensive and coordinated care system number ten. They are all unexceptional statements of the values and purposes that should shape the way services are delivered to families and children. The principles cited by Stroul and Friedman (1988) are that:
* Emotionally disturbed children should have access to a comprehensive array of services that address the child's physical, emotional, social and educational needs
* Emotionally disturbed children should receive individualised services in accordance with the unique needs and potentials of each child and guided by an individualised service plan
* Emotionally disturbed children should receive services within the least restrictive, most normative environment that is clinically appropriate
* The families and surrogate families of emotionally disturbed children should be full participants in all aspects of the planning and delivery of services
* Emotionally disturbed children should receive services that are integrated, with linkages between child caring agencies and programs and mechanisms for planning, developing and coordinating services
* Emotionally disturbed children should be provided with case management or similar mechanisms to ensure that multiple services are delivered in a coordinated and therapeutic manner and that they can move through the system of services in accordance with their changing needs
* Early identification and intervention for children with emotional problems should be promoted by the system of care in order to enhance the likelihood of positive outcomes
* Emotionally disturbed children should be ensured smooth transitions to the adult service system as they reach maturity
* The rights of emotionally disturbed children should be protected, and effective advocacy for emotionally disturbed children and youth should be promoted
* Emotionally disturbed children should receive services without regard to race, religion, national origin, sex, physical disability or other characteristics, and services should be sensitive and responsive to cultural differences and special needs.
(Stroul and Friedman, 1988, p. 11-15)
All of these principles are likely to be viewed with considerable sympathy by child welfare personnel.
Putting the System in Place
The issue as to how to operationalise these principles into a system of care is more complex. …